39DENTAL ANOMALIES AND THEIR VALUE IN HUMAN IDENTIFICATION: A CASE REPORT R. L. R. Tinoco, E. C. Martins, E. Daruge Jr, E. Daruge, F. B. Prado, P. H. F. Caria. a Department of Forensic Odontology, State University of Campinas, SP, Brazil. b Department of Morphology, Anatomy, State University of Campinas, SP, Brazil. a* a a a b b ABSTRACT Forensic odontology and anthropology provide valuable support with regard to human identification. In some cases, when soft tissue is destroyed, carbonized or absent for whatever reason, bones and teeth become the only source of information about the identity of the deceased. In human identification, anything different, such as variation from normality, becomes an important tool when trying to establish the identity of the deceased. This paper illustrates a positive identification case achieved by the diagnosis of an anomaly of tooth position, with confirmation using skull-photo superimposition. Even though forensic science presents modern techniques, in this particular case, the anomalous position of the canine played a key role on the identification, showing that the presence of a forensic dentist on the forensic team can be of great value. (J Forensic Odontostomatol 2010;28:1:39-43) Keywords: Forensic science, forensic dentistry, dental anomalies, human identification, skull-photo superimposition. Running title: Dental anomalies and human complete antemortem medical and/or dental 5-9 records, to be compared with the remains. For the identification of human remains, anything that distinguishes one person from another, such as a tattoo, or a variation from normality, becomes very important to the forensic team, greatly assisting the identification process. This is the reason why literature shows cases of abnormality, asymmetry and pathology narrowing the 3,10 search within missing persons files. However, few authors discuss the forensic value of dental anomalies that are commonly missed by medical examiners. These variations, analyzed by dental examiners, can potentially lead to a positive 2,3,6,7,11 identification. In the absence of antemortem information, the forensic team search for alternative 12sources of reference, such as photographs 14 15 and videotapes for personal features that may be identifiable at the postmortem examination. One of the techniques used in these cases is the skull-photo superimposition. Identification by this method is based on the matching of the outline and positional relationships between anatomical points on the face, and their locations on the 16-20 skull. This paper reports a recent positive identification case of a Brazilian girl, achieved by the discovery of an anomaly of tooth position and confirmed by skull-photo superimposition, showing the importance of the odontological analysis in this case, along with the anthropological evaluation of personal photographs for human identification. identification INTRODUCTION Anthropologists and odontologists usually have a leading role in the forensic team when dental structures are the only source of information for the identification of human remains. The resistance of teeth and their supporting tissues, even to fire and decomposition, makes them extremely useful 1-4 for identification purposes. In cases of carbonization, advanced decomposition, or partial destruction, all attention turns to the analysis of bones and teeth, and forensic experts need support from the family of suspected victims, on providing clear and with an age estimation between 18 and 30 years. and no restorations or decay present in any of the remaining dentition. Figure 1: Upper dental arch.4.! allowing the forensic experts to identify the same dental anomaly (23). searching for information about his 23 year-old missing niece. allowing proximal contact between the lateral incisor (22) and the first premolar (24). 1). in an attempt to reproduce the angle of the face as shown on the photograph (Fig. which. with buccally placed left canine Figure 2: Submitted antemortem photograph * The dental notation adopted is advocated by the FDI World Dental Federation After that coincidence.” This information drew the attention of the experts. and analyzed by the graphic manager Adobe Photoshop.14 positive identification. a man went to the local Medico-Legal Institute. 2). on the banks of a river. but there was a positional anomaly: the upper left * canine (23 ) was quite buccally displaced (Fig.40 CASE REPORT The remains of a caucasoid female.BRAZIL. is sufficient to establish a 3. but one tooth was “displaced forward. in the exact position as observed on the skull (Fig. the team took pictures of the skull using a digital camera of 6. Following storage in the database. was found in an advanced stage of decomposition. When asked about dental records. Approximately one month later. as well as all the other remaining visible teeth.0 megapixels. The images provided were digitalized. the size of the images ante and . SP . 3). according to many authors. who requested smiling antemortem photographs of the young woman. the man said she never had dental decay or restorations. The forensic odontology team noticed that there were five teeth lost postmortem. in São Paulo. stored in a database. interpupilar distance. followed by the skull-photo superimposition and craniofacial analysis (Fig. and presented as follows: 1. The prominence of the glabella and the depth of the nasal bridge are closely approximated by soft tissue covering this area. The mandible curve is similar to that of the facial jaw. 3.the image of the skull must be in exactly the same scale and angulation as the photograph. Figure 4: Superimposition skull-photo with two degrees of opacity . achieving the same scale on both images. at no point does the bone appear to project from the flesh. The mental protuberance of the mandible lies posterior to the point of the chin. 8. At the lateral superior one-third or the orbit the eyebrow continues horizontally as the orbital margin begins to curve inferiorly. conforms to the shape of the nose. 2. The eyebrow follows the supraorbital margin over the medial two-thirds. 10. using dental structures. and facial contour as size reference. The correct sizing and positioning of the images is essential . 6. The length of the skull considered from bregma to menton fits within the face. Computer-assisted craniofacial superimposition allows the operator to evaluate the fit between the skull and facial images by morphometrical 19 analysis. the nasal bones fall within the structure of the nose. and the imaginary continued line. 9. and the bregma is covered with hair. 4. 4). The line of the mandible corresponds to the line of the face 7. were the same as those suggested by Austin-Smith and 21 Maples. 5. The prosthion lies posterior to the anterior edge of the upper lip. The criteria used to judge the matching between the skull and photo. The width and length of the pyriform aperture falls inside the borders of the nose. Figure 3: Skull articulated and placed reproducing the angle of the photo. composed of lateral nasal cartilages in life. The width of the cranium fills the forehead area of the face.41 postmortem were adjusted. The orbits completely encase the eye including the medial and lateral folds. 34:621-2. caries and periodontitis. However. The importance of dental science in human identification: a casework report. Rev Bras Odontol 1998. sometimes they also can be unproductive for various reasons. Nagesh KR. CONCLUSION This particular positional canine. Singapore Med J 2009. and all associated dental restorations and prosthetic work. Variations in shape. Wood RE. In these situations. Coll Atropol 2000. although to the non-dental eye they all may look the same. Portuguese. Other elements such as a relationship between the time of the body decomposition and the period of disappearance of the victim. a forensic dental as part of the 13. 42:65-74.21 positive identification. 14. computer-assisted craniofacial superimposition was used to corroborate the positive identification. Shetty M. had by the medical examiner. Brkic H. 9.47:318-23. Goldstein M. Master´s thesis. 7. make the 2-4. estimated weight were also considered. Kirk NJ. emphasises the value of examiner being present forensic team during the investigation to seek identification of human remains. Tumang AJ. Collaboration of forensic odontology for identification postmortem. age. Sci Justice 2002.42 DISCUSSION Inexperienced observers may not be able to easily notice proportional and feature variation between skulls. . which played a identification process. Forensic odontology identification using smile photograph 2. Lumbosacral transitional vertebra: clinical and forensic implications. J Forensic Sci 2002. Portuguese. Kanchan T. Daruge E. 6. When the anterior dentition is recovered with the skull and a smiling antemortem photograph is available. acting as additional criteria. Dent Update 2007. 12. 1986:131. Silva RF et al. Dent Clin North Am 2001. Hong Kong: University of Hong Kong. size. 624-6. Silva RF et al. In this particular case. position. Daruge E. 10. Associated postmortem dental findings as an aid to personal identification. Pretty IA. Sweet D.37:33-42. A qualitative and quantitative analysis of the anterior dentition visible in photographs and its application in forensic odontology. Oliveira RN. proportion and detail between skulls. Menezes RG. Why a dentist for identification? Dent Clin North Am 2001. Principles of dental identification.45:237-51. age changes. Addy LD. Cadez J. an expert can demonstrate unlimited variation in shape.50:85-7. the shapes of the individual teeth and their relative positions are considered sufficiently distinctive for a 14. Warnick A. Keros J. the analysis of any available social and family photographs may help forensic professionals to identify the 14 deceased.95:25-37. 11. Pretty IA. Although forensic odontology and anthropology are extremely valuable when traditional identification methods are unsuitable or have failed (fingerprints. Miyajima F.11 dentition as individual as fingerprints. Skeletal identification using the frontal sinus region: a retrospective study of 39 cases.24 Suppl: 7983. Rothwell BR. 629-30. A very common reason is the absence or inaccuracy of dental records.137:141-6. 8. 5. showing that each skull is as individual as 22 each face. anomaly of the key role in the not been noticed This case report. Portuguese. color. Mass disaster management: the organization of a mass disaster dental identification team.55:11722. Alpha Omegan 2002. 3. Bilge Y et al. Forensic Sci Int 2003. Hereditary and environmental dental findings in identification of human remains. DNA). Daruge Jr E. The identification of a dismembered human body: a multidisciplinary approach. McKenna JJI. 4. personal characteristics such as sex. Confiability of forensic dental exam in human identification. Each dentition is considered to be unique. Galvão LCC. height. wear patterns. Kaic Z. Forensic dentistry: Identification of human remains. ROBRAC 2004. 45:253-70. Arq Odontol 2001. REFERENCES 1.13:46-50. allowing the team to confirm the identification achieved initially by odontological analysis of a smiling picture. Sinha P. Telephone: (55) 19 2106 5200 / (55) 21 9963 4751
[email protected]:44655. New York: Cambridge University Press. The reliability of skull/photograph superimposition in individual identification. Slabbert JH. Yoshino M et al. Forensic Sci Int 2001. An economized craniofacial identification system. Becker P. 901 – Caixa Postal 52. Forensic Sci Int 1997. Superimposition and reconstruction in forensic identification: a survey. In: Thompson T.74:125-34. Piracicaba – SP – CEP 13414-903. 17. 18.75:101-20. Marks MK. Gosh AK. Limeira. J Forensic Sci 1997. 20. Boca Raton: CRC Press. Evaluation of anatomical consistency in cranio-facial superimposition images. Forensic facial reconstruction.43 analysis – case reports. Forensic human identification: An introduction. 16. Jayaprakash PT et al. J Forensic Odontostomatol 2008.26:12-7. 22. 23. 21. Bennett JK. 19. Yoshino M et al. Auslebrook WA. Iscan MY. 2007. Computer-assisted skull identification system using video superimposition. 2008.90:231-44. Maples WR. Facial anthropology and reconstruction.117:109-19. Forensic Sci Int 1995. Address for Correspondence: Rachel Lima Ribeiro Tinoco Piracicaba Dental School – State University of Campinas Department of Forensic Odontology Av. Forensic Sci Int 1995. Wilkinson C. J Forensic Sci 1994. Austin-Smith D. 15. Digital video image capture in establishing positive identification.42:492-5. Black S.117:121-143. Forensic Sci Int 2001. Wilkinson C.com . Cranio-facial morphoanalysis: a new method for enhancing reliability while identifying skulls by photo superimposition. Wilson OL.